Alcohol consumption by women during pregnancy remains a major public health concern. Prenatal exposure to alcohol has been consistently shown to have detrimental effects on the developing fetus. Given the potential for prevention of this grave public health concern, research aimed at prevention efforts is crucial. Identification of risk factors for drinking during and throughout pregnancy is an important step in prevention. Existing studies have focused primarily on minority samples and have not included a comprehensive set of possible risk factors, such as depression, anxiety, psychological distress, and family history. Prevention efforts would benefit from studies which examine these variables, particularly given the well established link between affective disorders and drinking in women. The high prevalence of drinking problems in primary care provides an ideal setting for research efforts focused on prevention. Increased understanding of risk factors, including affective and psychological variables, will aid in designing intervention strategies and ultimately in prevention of the costly public health problems associated with alcohol consumption during pregnancy. Thus, the specific aims of this project are: 1) to examine risk factors which differentiate women who drink from those who do not drink while pregnant including demographic characteristics, personal substance use historyas well as family history of alcoholism, depression, anxiety, and psychological distress, and psychosocial factors and 2) to examine risk factors which differentiate women who continue to drink throughout pregnancy from those who discontinue use of alcohol during pregnancy on these variables. Based on pilot data, approximately 2700 pregnant women will be screened in primary care clinics in order to identify a sample of 150 women who are reporting drinking during pregnancy. Screen measures will include quantity and frequency of drinking, drinking consequences, as well as brief demographic, health and smoking items. Women meeting drinking criteria along with a control group of non-drinking women will be contacted during pregnancy and will be asked to complete a telephone interview which will include measures of alcohol use, family history, distress as well as structured diagnostic measures of depression and anxiety. Participants will also complete a brief postpartum interview to assess any changes in drinking since the prepartum interview, including reasons for changing. Results of this research will provide needed information on factors associated with drinking during pregnancy and will serve as a crucial first step in developing targeted secondary prevention strategies.